NPIMap

Organization Active NPI

Hale County Hospital

Doing business as Hale County Hospital Home Health

  • Home Health Agency
  • Greensboro, AL
National Provider Identifier
1114927639
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
10354 Issued in AL
Legal business name
HALE COUNTY HOSPITAL
Doing business as
Hale County Hospital Home Health
Practice address
506 Greene Street
Greensboro, AL 36744-2316
Phone
(334) 624-3066
Fax
(334) 624-3011
NPI assigned
Jul 27, 2005
Last updated
Jun 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HALE COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas O Lackey
Title
Administrator/Ceo
Phone
(334) 624-3024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 10354 AL Primary

Addresses

Primary practice location

506 Greene Street
Greensboro, AL 36744-2316

Mailing address

506 Greene Street
Greensboro, AL 36744-2316
Phone (334) 624-3066

Other names 1

  • HALE COUNTY HOSPITAL HOME HEALTH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080305000087 AL Part A Provider - Home Health Agency 3375528169 Practice locations: Greensboro, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114927639. Details of each certification follow.

Home health agency certification: CCN 017091

Legal name
HALE COUNTY HOSPITAL
Doing business as
HALE COUNTY HOSPITAL HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 18, 1992
Last certification
Jun 25, 2021
Ownership / control type
Proprietary
Organization structure
OtherNon-profit
Enrollment address
1207 State St
Unit 2
Greensboro, AL 36744-2012
HHA Branch

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hale County Hospital Home HealthCCN 017091 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Jun 18, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory
Tax ID family
Greene Cnty Hospnurs H2 organizations share this tax ID, including this one
Part of
Greene Cnty Hospnurs H

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

506 Greene St
Greensboro, AL 36744
Phone (334) 624-3066

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12717/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jack Weeden Individual Corporate DirectorBoard Member Oct 12, 2021
Dianne Bruner Individual W-2 Managing EmployeeChief Financial Officer Mar 5, 2024
Cynthia Renee Barnette Individual Corporate DirectorBoard Member May 31, 2012
Bernard T Martin Individual Corporate DirectorBoard Member Nov 27, 2012
Ulysess Johnson Individual Corporate DirectorBoard Member May 5, 1996
Hale County Healthcare Authority Organization, Greensboro, AL Operational/Managerial Control Nov 7, 1996
John a Dorsey Individual Corporate DirectorBoard Member Oct 23, 2011
Lorrie P Cook Individual Corporate DirectorBoard Member Feb 14, 2018
Meghan Bonds Individual Corporate DirectorBoard Member Dec 2, 2021
Tiffany Lashay Fondren Individual W-2 Managing EmployeeCeo Aug 4, 2014
Operational/Managerial ControlCeo Aug 20, 2021
Elizabeth O Rayford Individual W-2 Managing EmployeeAssistant Cfo Aug 19, 2009
Ethel Miller Individual Corporate DirectorBoard Member Nov 17, 2022
Tony O Lee Individual Corporate DirectorBoard Member Mar 5, 2009

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1114927639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 GREENE STREET",
            "city": "GREENSBORO",
            "state": "AL",
            "postal_code": "367442316",
            "telephone_number": "334-624-3066",
            "fax_number": "334-624-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 GREENE STREET",
            "city": "GREENSBORO",
            "state": "AL",
            "postal_code": "367442316",
            "telephone_number": "334-624-3066",
            "fax_number": "334-624-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALE COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HALE COUNTY HOSPITAL",
        "enumeration_date": "2005-07-27",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "334-624-3024"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AL",
            "license": "10354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HALE COUNTY HOSPITAL HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, AL

Sources for this page

Verify at the official NPI Registry.